Alcohol Questionnaire

 

1 How often do you have a drink containing alcohol?

Never

Monthly or less
2 to 4 times a month
2-3 times a week
4 or more times a week

2 How many standard drinks of alcohol (alcoholic units) do you have on a typical day when you are drinking?

1 or 2
3 or 4
5 or 6
7 to 9
10 or more

3 How often do you have 6 or more standard drinks on one occassion?

Never
Less than monthly
Monthly
Weekly
Daily or almost daily

4 How often during the last year have you found that you were not able to stop drinking once you had started?

Never
Less than monthly
Monthly
Weekly
Daily or almost daily

5 How often during the last year have you failed to do what was normally expected of you because of your drinking?

Never
Less than monthly
Monthly
Weekly
Daily or almost daily

6 How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session?

Never
Less than monthly
Monthly
Weekly
Daily or almost daily

7 How often during the last year have you had a feeling of guilt or remorse after drinking?

Never
Less than monthly
Monthly
Weekly
Daily or almost daily

8 How often during the last year have you been unable to remember what happened the night before because you had been drinking?

Never
Less than monthly
Monthly
Weekly
Daily or almost daily

9 Have you or someone else been injured as a result of your drinking? No
Yes, not in the last year
Yes in the last year
10 Has a relative, friend, doctor or other health worker been concerned about your drinking or suggested you cut down? No
Yes, not in the last year
Yes in the last year
Scoring

The minimum score (for non-drinkers) is 0

The maximum possible score is 40.

Your Score:

 

A score of 8 or more indicates a strong liklihood of hazardous or harmful alcohol consumption. If you scored above 8, you might want to contact the agency for some advice.

 

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